Sample SPA

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Republic of the Philippine)

City of Cotabato ) s.s.


x- - - - - - - - - - - - - - - -x

SPECIAL POWER OF ATTORNEY

I, MS. ABCD, of legal age, married and a resident of Cotabato City, do hereby constitute and appoint, MR.
XYZ, of legal age, Filipino, and with residence and postal address at Davao City, to be my true and lawful
attorney in fact and in my name, place and stead to do the following acts, to wit:

1. To transact, follow-up, process, apply and/or request for Building Occupancy Permit of the property
located at Lot 7, Block 3, Royal Pines Subdivision, Matina, Davao City;
2. To transact, follow-up, process, apply and/or request for Davao Light and Power Company (DLPC) of
Permanent Electrical Supply of the property located at Lot 7, Block 3, Royal Pines Subdivision, Matina,
Davao City;
3. To sign documents in my behalf in furtherance of such power and authority as provided herein and hereby
ratifying and confirming all that my said attorney shall lawfully do, have done or cause to be done by
virtue hereof.

IN WITNESS WHEREOF, I have hereunto set my hand this 15TH day of NOVEMBER 2022 at Cotabato City
Philippines.

MS. ABCD
Principal

CONFORME:

MR. XYZ
Attorney-in-Fact
LTO Driver’s License No. MO1-01234567

Signed in the Presence of:

________________________ _________________________

ACKNOWLEDGMENT

Republic of the Philippine)


City of Cotabato ) s.s.
x- - - - - - - - - - - - - - - -x

BEFORE ME, a Notary Public for and in the City of Cotabato, this 15th day of November 2022 at Cotabato City Philippines,
personally appeared ABCD and XYZ, known to me to be the same person who executed the foregoing instrument and who
acknowledges to me that the same is their free and voluntary act and deed.

This instrument consisting of single page including where this acknowledgment is written, has been signed by the parties
together with their instrumental witnesses, and referred to as Special Power of Attorney.

WITNESS MY HAND AND SEAL on the date and place first written.

Doc No. ___


Page No.___
Book No. ___
Series of 2022.

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